Comparative efficacy of Bruton tyrosine kinase inhibitors in high-risk relapsed/refractory CLL: a network meta-analysis.

Given the lack of head-to-head trials comparing next-generation BTKis used to treat high-risk R/R disease, a network meta-analysis(NMA) was performed to estimate their relative efficacy.

鉴于缺乏直接比较新一代BTKis用于治疗高风险R/R疾病的头对头试验，进行了一项网络荟萃分析（NMA），以估计它们的相对疗效。

High-risk populations were defined based on the prespecified definitions within each trial, including patients with del(17p) and/or TP53 mutations in the ALPINE (n = 150) and ASCEND (n = 86) trials, and del(17p)/del(11q) in the ELEVATE-RR (n = 533) trial. Bayesian NMAs found zanubrutinib to be the most efficacious treatment for high-risk patients, with significantly reduced risk of progression or death compared with ibrutinib (hazard ratio[HR], 0.49; 95% credible interval [CrI], 0.31-0.78), acalabrutinib (HR, 0.55; 95% CrI, 0.32-0.94), and bendamustine + rituximab or idelalisib + rituximab (BR/IR; HR, 0.12; 95% CrI, 0.05-0.26).

高风险人群的定义基于每个试验中预先设定的定义，包括在ALPINE试验（n = 150）和ASCEND试验（n = 86）中具有del(17p)和/或TP53突变的患者，以及在ELEVATE-RR试验（n = 533）中的del(17p)/del(11q)患者。

Differences in overall survivaldemonstrated a numerical trend favoring zanubrutinib (probability better than ≥80%) compared with ibrutinib (HR, 0.59; 95% CrI, 0.31-1.11), acalabrutinib (HR, 0.72; 95% CrI, 0.35-1.50), and BR/IR (HR, 0.65; 95% CrI, 0.23-1.75).

总生存期的差异显示出一种数值趋势，即泽布替尼优于伊布替尼（HR，0.59；95% CrI，0.31-1.11），阿卡布替尼（HR，0.72；95% CrI，0.35-1.50），以及BR/IR（HR，0.65；95% CrI，0.23-1.75），泽布替尼的改善概率大于或等于80%。

Rates of response also demonstrated trends favoring zanubrutinib compared with acalabrutinib, with significant results compared with ibrutinib.

反应率也显示出zanubrutinib相较于acalabrutinib的有利趋势，与ibrutinib相比结果显著。

The NMA suggests that the most efficacious BTKi for patients with high-risk R/R CLL is zanubrutinib.

网络荟萃分析（NMA）表明，对于高危复发/难治性慢性淋巴细胞白血病（R/R CLL）患者，zanubrutinib是最有效的BTK抑制剂。